• Ja-Liang Lin, Dan-Tzu Lin-Tan, Kuan-Hsing Chen, and Wen-Hung Huang.
• Division of Clinical Toxicology and Nephrology, Department of Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Chang Gung University, School of Medicine, Taipei, Taiwan, ROC. jllin99@hotmail.com
• Crit. Care Med. 2006 Feb 1; 34 (2): 368-73.

ObjectiveParaquat is widely used in the world, and all treatments for paraquat poisoning have been unsuccessful. Many patients have died of paraquat poisoning in developing countries. A novel anti-inflammation method was developed to treat severe paraquat-poisoned patients with >50% to <90% predictive mortality: initial pulse therapy with methylprednisolone (1 g/day for 3 days) and cyclophosphamide (15 mg/kg/day for 2 days), followed by dexamethasone 20 mg/day until Pao2 was >11.5 kPa (80 mm Hg) and repeated pulse therapy with methylprednisolone (1 g/day for 3 days) and cyclophosphamide (15 mg/kg/day for 1 day), which was repeated if Pao2 was <8.64 kPa (60 mm Hg).DesignRandomized controlled trial.SettingAcademic medical center in Taiwan.PatientsTwenty-three paraquat-poisoned patients with >50% and <90% predictive mortality assessed by plasma paraquat levels were prospectively and randomly assigned to the control and study groups at a proportion of 1:2.InterventionsThe control group received conventional therapy and the study group received the novel repeated pulse treatment with long-term steroid therapy.Measurements And Main ResultsWe measured patient mortality during the study period. There was not a different distribution of basal variables between the two study groups. The mortality rate (85.7%, six of seven) of the control group was higher than that of the study group (31.3%, five of 16; p = .0272).ConclusionsThe novel anti-inflammatory therapy reduces the mortality rate for patients with severe paraquat poisoning.

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